PurposeThis study reports the short- and mid-term benefits of an eight-session emotion and self-regulation group intervention ecologically boosted through daily app-based prompts. The intervention was designed for breast cancer patients in the early survivorship period meeting criteria for clinical levels of psychological symptoms. MethodsPatients were randomly assigned to the immediate intervention arm (n = 61; intervention received immediately) or to the delayed intervention arm (n = 59; intervention received 5 months later). Psychological symptoms, including anxiety, depressive symptoms, emotional distress, fear of cancer recurrence (FCR), worry, and intrusive thoughts were assessed through questionnaires. Emotion regulation was assessed in a dynamic emotion regulation task and in everyday life. Assessments were completed at baseline (T1), 5 months (T2) and 10 months (T3) later. ResultsTreated patients reported lower levels of worry and intrusive thoughts. They improved their ability to down-regulate the intensity of their negative emotions when exposed to cancer-related triggers in the dynamic emotion regulation task. They reported fewer and less intense negative emotions and more positive emotions in their everyday life. Benefits were maintained 5 months later, except for positive emotions in everyday life. ConclusionsThe results showed that focusing on emotion regulation is a relevant approach in the treatment of psychological symptoms for breast cancer patients in the early survivorship period meeting criteria for clinical levels of psychological symptoms. The intervention led to changes in patients' dynamic and everyday life emotion regulation. Consolidation sessions may be needed to sustain benefits in positive emotions and to increase the effect sizes.

Objective Cancer-related communication is critical for parents' and children's adaptation to the disease. This randomized pilot study was conducted to test the feasibility, acceptability, and efficacy of a 4-session intervention designed to improve parents' communication. Methods A 4-session intervention was developed to aid parents to support their children through more open/adapted communication. Sixty-six parents were assigned randomly to informational booklet with and without 4-session support intervention arms. Parents' communication self-efficacy, communication behaviors, communication difficulties, knowledge about age-appropriate communication, theoretical knowledge about concerns of children, parenting concerns, and distress were assessed by questionnaires at baseline and post-interventions. Multivariate analyses of variance were performed to compare data between and within groups over time. Results The intervention attrition rate was 6%. Data from 60 participants were included in analyses. Parents in the informational booklet with 4-session support group increased their communication self-efficacy (F = 4.5, p = 0.04), reduced communication difficulties (F = 4.0, p = 0.05), and increased their knowledge about how to communicate (F = 4.8, p = 0.03). Conclusion The results indicate that the 4-session intervention is acceptable, and shows preliminary evidence of efficacy. Practice implications A short support intervention associated with an informational booklet may be useful for parents wishing to improve their communication with their children.

Purpose of review When a parent is diagnosed with cancer, the entire family is impacted. Patients with cancer and co-parents may no longer feel able to fulfill their parenting roles. The aims of this article are to describe interventions designed to support parenting in the oncological context and to make suggestions for the development and assessment of such interventions. Recent findings Ten parenting support interventions published in the last 10 years in oncology were identified, among which four randomized controlled trials (RCTs). The therapeutic aims, techniques, and modalities of these interventions were heterogeneous. Five main therapeutic aims were addressed to: increase parents' knowledge, promote parents' emotion regulation, enhance parents' self-efficacy related to parenting, promote parents' support of their children's reactions and coping strategies, and promote open and appropriate parent-child communication. Few studies have combined informational resources with experiential techniques. Very few studies examining the efficacy of parenting support interventions have been published. There is still a need to develop, test, and compare interventions that meet the many needs of parents and their children. Suggestions are made about the contents and formats of parenting support interventions in oncology.

Objective: Cancer-related communication is critical for patients' and caregivers' adaptation to illness. This randomized pilot study was conducted to test the feasibility, acceptability, and efficacy of a specific dyadic intervention to improve communication. Methods: A four weekly-session intervention was developed to reinforce cancer-related patient-caregiver communication. Patients receiving treatment for any diagnosed cancer, and their caregivers, were recruited from two oncology clinics in Belgium. Sixty-four patient-caregiver dyads were assigned randomly to intervention and waitlist groups. Cancer-related dyadic communication, dyadic coping and emotional distress were assessed at baseline and post-intervention. Results: The intervention attrition rate was 6 %. Linear mixed models were performed on 60 dyads. Significant two-way group x time interaction indicated improvement in participants' cancer-related dyadic communication frequency (beta = -1.30; SE = 0.31; p =.004), self-efficacy (beta = -10.03; SE = 3.90; p =.011) and dyadic coping (beta = -5.93; SE = 2.73; p =.046) after the intervention. Conclusion: These results indicate that the brief dyadic communication intervention is feasible and acceptable, and show preliminary evidence of efficacy. Practice implications: Encouraging patients and caregivers to discuss personal cancer-related concerns may improve their ability to cope with the illness together. (C) 2020 Elsevier B.V. All rights reserved.

Objectives: This descriptive study assesses how physicians' decisional conflict influences their ability to address treatment outcomes (TOs) in a decision-making encounter with an advanced-stage cancer simulated patient (SP). Methods: Physicians (N = 138) performed a decision-making encounter with the SP trained to ask for TOs information. The physicians' decisional conflict regarding patients' cancer treatments in general was assessed with the General Decisional Conflict Scale (Gen-DCS). The physicians' decisional conflict regarding the SP's cancer treatments was assessed with the Specific Decisional Conflict Scale (Spe-DCS). Physicians' ability to address TOs during the encounter was assessed with an interaction analysis system: the Multi-Dimensional Analysis of Patient Outcome Predictions (MD.POP). Weekly time spent with cancer patients was assessed with a questionnaire. Results: Physicians' Spe-DCS (beta = -.21 ; p = .014) and weekly time spent with cancer patients (beta = .22 ; p = .008) predicted the number of TOs addressed during the encounter. Spe-DCS scores predicted nearly all MD.POP dimensions (r = -.18 ; p = .040 to r = -.30 to p < .001) whereas Gen-DCS scores predicted nearly none MD.POP dimensions. Conclusion: Physicians' specific decisional conflict interferes with their ability to address TOs in a decision-making encounter with an advanced-stage cancer SP. Practice implications: Physicians should be trained to address TOs according to patient preferences, despite their own decisional conflict. (C) 2020 Elsevier B.V. All rights reserved.

Objective: Our first objective was to develop the Multi-Dimensional analysis of Patient Outcome Predictions (MD. POP), an interaction analysis system that assesses how HCPs discuss precisely and exclusively patient outcomes during medical encounters. The second objective was to study its interrater reliability. Method: The MD. POP was developed by consensus meetings. Forty simulated medical encounters between physicians and an actress portraying a patient were analysed. Interrater reliability analysis was conducted on 20 of those simulated encounters. Results: The MD. POP includes six dimensions: object, framing, value, domain, probability and form of POP. The coding method includes four steps: 1) transcription of the encounter, 2) POP identification, 3) POP dimension coding and 4) POP scoring. Descriptive analyses show that the MD. POP is able to describe verbal expressions addressing the patient's outcomes. Statistical analyses show excellent interrater reliability (Cohen's Kappa ranging from 0.92 to 0.94). Conclusion: The MD. POP is a reliable interaction analysis system that assesses how HCPs discuss patient medical, psychological or social outcomes during medical encounters. Practical implication: The MD. POP provides a measure for researchers to study how HCPs communicate with patients about potential outcomes. Results of such studies will allow to provide recommendations to improve HCP's communication about patients' outcomes. (c) 2017 Elsevier B.V. All rights reserved.

Although previous studies have reported the efficacy of communication skills training (CST) programs, specific training addressing communication about uncertainty and hope in oncology has not yet been studied. This paper describes the study protocol of a randomized controlled trial assessing the efficacy of a CST program aimed at improving physician ability to communicate about uncertainty and hope in encounters with cancer patients.

Relatives are omnipresent in cancer care and commonly accompany cancer patients to physician consultations, increasing the complexity of the resultant communication. Relatives can provide important collaborative history, support, and advocate for their loved one, as well as have their own needs addressed. Relatives may also desire to protect their loved ones, and challenges arise if they invite the clinician to collude in keeping secrets. Optimally including relatives in a consultation is a complex task. Specific skills—for instance, asking permission, using circular questions and offering summaries—can enrich triadic communication. When breaking bad news, strategies for three-person consultations that have been used in communication skills training deliver benefits to both patients and their relatives. The successful accomplishment of three-person consultations is one hallmark of the mature clinician. It requires skill and time, but can certainly promote optimal patient care.

Despite the well‐known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy.

Objective: Although cancer patients frequently experience self-perceived burden to others, this perception has not been enough studied. The aim of this study was to investigate the prevalence of self-perceived burden to the primary caregiver (SPB-PC) and associated factors in an older patient population with hematologic malignancies at the time of chemotherapy initiation.Methods: In total, 166 consecutive patients with hematologic malignancies aged >= 65 years were recruited at the time of chemotherapy initiation. Patients' SPB-PC was assessed using a 100-mm visual analogue scale (VAS). Characteristics potentially associated with SPB-PC, including sociodemographic and medical characteristics, physical functioning status (Karnofsky performance score, activities of daily living (ADL)/instrumental ADL), symptoms (fatigue, pain, nausea, quality of life), psychological distress (Hospital Anxiety and Depression Scale (HADS)), perceived cognitive function (Functional Assessment of Cancer Therapy Cognitive (FACT-Cog) Scale), and patients'/primary caregivers' personal relationship characteristics (family tie, support), were assessed.Results: Thirty-five percent of patients reported moderate to severe SPB-PC (VAS >= 50 mm). Patients' SPB-PC was associated with lower Karnofsky performance (beta = -0.135, p = 0.058) and ADL (beta = -0.148, p = 0.037) scores, and higher HADS (beta = 0.283, p<0.001) and FACT-Cog perceived cognitive impairments subscale (beta = 0.211, p = 0.004) scores. The proportion of explained variance was 23.5%.Conclusions: Health care professionals should be aware that about one third of older cancer patients experience moderate to severe SPB-PC at the time of chemotherapy initiation. They should adapt their support of patients who report such a feeling. Copyright (C) 2016 John Wiley & Sons, Ltd.

Background and purposeThe aim of this study was to assess the efficacy of a 38-h communication skills training program designed for multidisciplinary radiotherapy teams.Materials and methodsFour radiotherapy teams were randomly assigned to a training program or to a waiting list. Assessments were scheduled at baseline (T1) and then after the training was completed or four months later (T2), respectively. Communication around radiotherapy delivery was assessed based on audio recordings of the first and last radiotherapy sessions in order to assess team members’ communication skills and the expression of concerns by breast cancer patients (analyzed with content analysis software LaComm).Results198 radiotherapy sessions were recorded. During the first radiotherapy sessions, members of the trained teams exhibited more assessment skills (p=0.048), provided more setting information (p<0.001), and used more social words (p=0.019) compared to the members of the untrained teams. During the last radiotherapy session, members of the trained teams used more assessment skills (p=0.004) and patients interacting with members of the trained teams expressed more sadness words (p=0.023).ConclusionTraining of multidisciplinary teams has the potential to transfer skills that affect the short exchanges that take place around radiotherapy delivery.

OBJECTIVE:To compare in a multicenter randomized controlled trial the benefits in terms of anxiety regulation of a 15-session single-component group intervention (SGI) based on support with those of a 15-session multiple-component structured manualized group intervention (MGI) combining support with cognitive-behavioral and hypnosis components. METHODS:Patients with nonmetastatic breast cancer were randomly assigned at the beginning of the survivorship period to the SGI (n = 83) or MGI (n = 87). Anxiety regulation was assessed, before and after group interventions, through an anxiety regulation task designed to assess their ability to regulate anxiety psychologically (anxiety levels) and physiologically (heart rates). Questionnaires were used to assess psychological distress, everyday anxiety regulation, and fear of recurrence. Group allocation was computer generated and concealed till baseline completion. RESULTS:Compared with patients in the SGI group (n = 77), patients attending the MGI group (n = 82) showed significantly reduced anxiety after a self-relaxation exercise (P = .006) and after exposure to anxiety triggers (P = .013) and reduced heart rates at different time points throughout the task (P = .001 to P = .047). The MGI participants also reported better everyday anxiety regulation (P = .005), greater use of fear of recurrence-related coping strategies (P = .022), and greater reduction in fear of recurrence-related psychological distress (P = .017) compared with the SGI group. CONCLUSIONS:This study shows that an MGI combining support with cognitive-behavioral techniques and hypnosis is more effective than an SGI based only on support in improving anxiety regulation in patients with breast cancer.

PURPOSE:This study assessed the efficacy of a 38-hour communication skills training program designed to train a multidisciplinary radiotherapy team.METHODS:Four radiotherapy teams were randomly assigned to a training program or a waiting list. Assessments were scheduled at baseline and after training for the training group and at baseline and 4 months later for the waiting list group. Assessments included an audio recording of a radiotherapy planning session to assess team members' communication skills and expression of concerns of patients with breast cancer (analyzed with content analysis software) and an adapted European Organisation for Research and Treatment of Cancer satisfaction with care questionnaire completed by patients at the end of radiotherapy.RESULTS:Two hundred thirty-seven radiotherapy planning sessions were recorded. Compared with members of the untrained teams, members of the trained teams acquired, over time, more assessment skills (P = .003) and more supportive skills (P = .050) and provided more setting information (P = .010). Over time, patients interacting with members of the trained teams asked more open questions (P = .022), expressed more emotional words (P = .025), and exhibited a higher satisfaction level regarding nurses' interventions (P = .028).CONCLUSION:The 38-hour training program facilitated transfer of team member learned communication skills to the clinical practice and improved patients' satisfaction with care.